Katz Ingrid T, Ybarra Michele L, Wyatt Monique A, Kiwanuka Julius P, Bangsberg David R, Ware Norma C
Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA.
AIDS Care. 2013;25(2):258-64. doi: 10.1080/09540121.2012.701718. Epub 2012 Jul 27.
With more than half of new infections occurring among youth, HIV/AIDS remains a major contributor to morbidity and mortality in Uganda. Semi-structured interviews were performed with 48 adolescents and 15 adult key informants in a rural Ugandan community to identify influences on adolescent sexual decision-making. Inductive data analytic methods revealed five thematic influences: (1) social pressure, (2) decline of the Senga (a familial figure who traditionally taught female adolescents about how to run a household), (3) cultural barriers to condom use, (4) knowledge of HIV transmission and modes of prevention, and (5) a moral injunction against sex before marriage. Influences were classified as HIV/AIDS risk and protective factors and organized to form an explanatory framework of adolescent sexual risk-taking. Risk factors pull youth toward risky behavior, while protective factors push them away. Predominance of risk over protective influences explains persistent sexual risk-taking by Ugandan youth. HIV prevention programs designed for Ugandan adolescents should take competing factors and sociocultural and economic influences into account.
由于超过一半的新感染病例发生在年轻人中，艾滋病毒/艾滋病仍是乌干达发病和死亡的主要原因。在乌干达农村社区，对48名青少年和15名成年关键信息提供者进行了半结构化访谈，以确定对青少年性决策的影响。归纳数据分析方法揭示了五个主题影响因素：（1）社会压力，（2）桑加（传统上教导女性青少年如何持家的家族人物）角色的衰落，（3）使用避孕套的文化障碍，（4）艾滋病毒传播和预防方式的知识，以及（5）婚前性行为的道德禁令。这些影响因素被归类为艾滋病毒/艾滋病风险因素和保护因素，并组织起来形成一个青少年性冒险行为的解释框架。风险因素促使年轻人走向危险行为，而保护因素则使他们远离危险行为。风险因素超过保护因素的主导地位解释了乌干达年轻人持续的性冒险行为。为乌干达青少年设计的艾滋病毒预防项目应考虑到相互竞争的因素以及社会文化和经济影响。
